Willie Brooks
Individual provider Active NPI Driver · Tennille, GA
NPI 1013727031 · NPPES record last updated Jan 11, 2025
Key facts
- NPI
- 1013727031
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- Practice address
- 490 Irwin Ave
Tennille, GA 31089-4213 - Phone
- (478) 456-0129
- NPI assigned
- Jan 11, 2025
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bellkerr Transportation | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | Yes |
Addresses
Primary practice location
490 Irwin Ave
Tennille, GA 31089-4213
Mailing address
490 Irwin Ave
Tennille, GA 31089-4213
Other providers in Tennille, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.